JPH11299805A - Tissue restoration device for human body and attachment method for the device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a new interarticular cartilage tissue restoration device. SOLUTION: The interarticular cartilage tissue restoration device is provided with a thin and long main body 8 provided with a sharp tip 4. Plural groove parts 10 and 12 are cut over a tip part and a base end part along the length direction of the device main body, plural edges are formed, a groove with the edge provided on a front half part near the tip part whose boundary is the middle of the tip part and the base end part is opened toward the base end part and the groove with the edge provided on a second half part near the base end part is opened toward the tip part. The restoration device is mounted to the cylinder part of an applicator, the cylinder part of the applicator is inserted into tissues to be restored such as the tissues of the lacerated interarticular cartilage of a knee joint in a vertical direction to the tissues, the applicator is operated, the restoration device is gnawed into the tissues, the restoration device is detained inside the tissues so as to sew the tissues together and the tissues are restored.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical operation method and apparatus for repairing injuries (tears) of interarticular cartilage (half moon).

[0002]

BACKGROUND OF THE INVENTION Interarticular cartilage (half moon) is a crescent-shaped tissue structure of fibrocartilage tissue located in the knee joint between the tibial condyle and the femoral condyle. The inter-articular cartilage, which is actually an extension of the tibia, makes the tibial dish deep enough to better accommodate the opposing curvature of the articulating surface of the femoral condyle.

[0003] The most common type of injury to the knee joint is damage (tearing) of the joint cartilage. For example, when a sudden change occurs in the movement of the knee joint, for example, when the knee joint is bent and twisted (rotated), or when the knee joint is stretched and twisted (rotated), it is greatly affected. When the interarticular cartilage moves between the condyles of the thigh and the cervical condyle and is pinched, the cartilage is damaged (tears). Articular cartilage damage was originally treated by removing the articular cartilage (half a month) by a procedure called menissectomy (knee cartilagectomy). However, when part or all of the joint cartilage is removed,
It was found that the knee joint became unstable due to osteoarthritis.

[0004] In order to address the above problems, surgeons have tried to repair the torn (torn) joint cartilage laceration by suturing to retain as much of the joint cartilage (half moon) as possible. Treated. However, suturing the interarticular cartilage laceration is, like the menis sectomy, an incision operation from the start and requires a large incision, and therefore requires a long period of rehabilitation and recovery. With the development of surgical instruments, arthroscopic meniscal repair procedures in which lacerations are sewn using long surgical needles have been performed.

[0005] In recent years, for the repair of inter-articular cartilage, temporary tack fasteners (tack) and screws (screw), which can be used like an arthroscope, have been developed, eliminating the need for suturing and facilitating surgical operations. Became. In this regard, U.S. Patent Nos. 4,873,976; 4,884,572;
4,895,148; 4,924,865; 4,97
6,715; 5,059,206; 5,129,90
6; 5,562,672 and 5,569,252. Known tacks and surgical procedures using them have various disadvantages, for example, the need to specially prepare the articular cartilage prior to insertion.

[0006]

To repair a torn joint cartilage, as described above, resection by open surgery, repair by sutures, repair by fasteners and screws, etc. are performed. All means have the above-mentioned disadvantages, and it is an object of the present invention to improve these disadvantages.

SUMMARY OF THE INVENTION The present invention provides an improved device for repairing damaged tissue of the human body, such as interarticular cartilage, which is used by attaching to a specially designed insertion gun. Can be easily, quickly, and accurately repaired.

[0008]

SUMMARY OF THE INVENTION In summary, the present invention provides a device for repairing an interarticular cartilage or other tissue having a cylindrical distal end, a proximal end, and a plurality of crescent-shaped grooves. It has a device body. The plurality of grooves near the distal end of the device are open toward the proximal end side, and the plurality of grooves near the proximal end of the device are facing the distal end side. Mouth open. The grooves are staggered on opposite sides of the device.

To illustrate the use of the device for repairing a torn articular cartilage, to insert the device into a torn joint of a torn articular cartilage, the device must first be inserted into the elongated tube of an applicator. Load it. In this loading operation, the spring-biased plunger passed through the cylinder is retracted in the cylinder while resisting the urging force, and a space sufficient for the device loading is provided at the tip in the cylinder. The device is loaded in a preloading manner such that the proximal end of the device abuts the distal end of the plunger of the applicator. Next, the tubular part loaded with the device is inserted into the lacerated part of the interarticular cartilage of the incised knee joint. This insertion is performed perpendicularly to the laceration, and is inserted in such a manner as to strike a harpoon on the laceration. When the insertion is completed, the trigger of the applicator is pulled to release the restrained spring biasing force, and the plunger is biased by the spring biasing force and strokes toward the distal end of the cylindrical portion. The forward stroke of the jar causes the loaded device to bite into the tear like a fired harpoon and suture the cut tear together, thereby repairing the tear. This device is placed in a laceration to be repaired like an indwelling needle, but since it is made of a bioabsorbable material such as PLLA, there is no problem if it is placed in the laceration.

The device and method of the present invention can be used to repair cartilage bone, cartilage bone, bone, skin and ligaments, such as bone, skin, and ligaments, as well as damaged articular cartilage (half moon). Thus, the present invention is widely used for tissue repair of a damaged human body.

[0011]

Next, the present invention will be described in detail with reference to examples. Referring to FIG. 1 to FIG. 3, an inter-articular cartilage repair device 2 of the present invention includes a pointed trocar-shaped distal end portion 4, a rounded proximal end portion 6, and a cylindrical main body 8. Have. A plurality of half-moon-shaped (crescent-shaped) grooves 10 and 12 are provided along the main body 8 in a staggered arrangement on opposite sides of the device, respectively, and have a harpoon-like shape.

The groove is formed at an angle of about 30 ° with respect to the longitudinal axis of the main body 8. The groove 10 on the distal end side of the device 2 is open toward the proximal end, and the groove 12 on the proximal end side of the device 2 is open toward the distal end. The base of each groove is entirely hollow. The edges of the open mouths of the adjacent grooves on each side edge of the main body 8 converge to form edges 10a and 12a, which constitute an anchor portion that bites into the tissue of the inter-articular cartilage.

The grooves are arranged on both sides of the main body 8 at a constant and equal pitch. As shown in FIG. 2, the opposing grooves 10 and 12 are arranged alternately and are shifted by 1/2 pitch. The groove 10 and the groove 12 are provided at the center of the main body 8 as a boundary, and the groove 10 is larger than the groove 12. Therefore, the edge 10 a of the groove 10 is larger than the edge 12 a of the groove 12. Also, the protruding tip is short, and the edge 12a is sharper. The two edges 10a,
The back of 12a is curved as shown, and in particular the back of edge 10a is such that when the device 2 is inserted into the tissue of the articular cartilage, it does not go against the insertion.

The length of the device 2 is, for example, 10 mm, 1
The dimensions are 2 mm and 14 mm, which are appropriately selected from those having a length dimension.
Choose a size that does not protrude from the bonded capsule when the device is inserted into the joint cartilage.

To insert the device 2 into the torn articular cartilage, the device 2 is first mounted in an elongated tubular portion 18 of an applicator 14 equipped with a spring-biased plunger, as shown in FIGS. I do. Applicator 1
No. 4 is disclosed in U.S. Pat.
It has almost the same structure as that described in Japanese Patent No. 546,957. The applicator 14 includes a spring-biased plunger 16, which has a cylindrical portion 18.
And slides in the front-rear direction along the axial direction of the cylindrical portion. Then, the plunger 16 of the applicator 14 is retracted, and the repair device 2 is loaded into the distal end of the plunger 16 retracted in the cylindrical portion 18 from the distal end of the opening of the cylindrical portion. The retreat of plunger 16
The knob 20 connected to the base end 16a of the plunger 16 may be pulled backward while resisting the urging force of the spring 28.
The device 2 to be loaded into the tube portion 18 is inserted into the tube portion from the proximal end side, and is loaded so that the proximal end portion 6 of the device 2 comes into contact with the retracted distal end of the plunger 16 of the applicator 14.

Once the device 2 is loaded into the tube 18 of the applicator 14, the handle 22 is then grasped and the tube 18 of the applicator 14 is inserted into the incision of the knee, and the tip 23 of the tube 18 is inserted into the joint cartilage. Insert vertically into the area adjacent to the laceration. At this point, remove the safety device of the applicator 14 and pull the trigger 26 of the applicator 14,
The compressed spring 28 is released to advance the plunger 16, and the advance of the plunger 16 causes the device 2 to be fired from the cylindrical portion 18 to the rupture site with the distal end thereof as a head, and the device 2 is inserted into the laceration site. Then, the laceration is sutured. If the protruding part of the repair device 2 needs to be cut, it can be cut through another small cut. The repair device of the present invention is advantageously molded from a material that can be absorbed physiologically (body) (bioabsorbable), for example a material such as PLLA.

FIG. 7 shows the use of three repair devices 30, 32, 34 according to the present invention to provide a tear 38 in the joint cartilage.
Is shown in a state where the suturing is performed and the suturing is performed. The devices are inserted into the joint cartilage tissue 36 as shown, and the dissected tears 38 are sutured together. Each edge 10a in the first half of the edge portion of each device prevents the device 2 from moving in the opposite direction opposite to the piercing direction, and each edge 12a in the second half.
Prevents the device 2 once pierced from moving in the piercing direction, and controls excessive piercing.

The device and method according to the invention can be used not only for repairing tears in the articular cartilage (half moon), but also for repairing bodily tissues such as cartilage bone, cartilage bone, bone, skin and ligaments. .

The above embodiments are not intended to limit the present invention, and those skilled in the art can make various modifications and modifications.
It is intended to cover the entire technical scope described in the claims.

[0020]

The device and the method according to the present invention not only repair the tear of the interarticular cartilage (half moon), but also the cartilage bone,
It can be easily and reliably used to repair bodily tissues such as cartilage bone, bone, skin and ligaments.

[Brief description of the drawings]

FIG. 1 is a side view of a repair device according to an embodiment of the present invention.

FIG. 2 is a plan view of the repair device according to the embodiment of the present invention.

FIG. 3 is an end view of a proximal end portion of the repair device according to the embodiment of the present invention.

FIG. 4 is a side view schematically showing an internal mechanism of an applicator for using the repair device of the present invention.

FIG. 5 is an explanatory sectional view of a main part of the applicator of FIG. 4;

FIG. 6 is a perspective view of the applicator of FIG. 4;

FIG. 7 is an explanatory diagram of a tissue repaired by the repair device of the present invention, particularly a repaired state of a laceration of interarticular cartilage.

[Explanation of symbols]

2 Inter-articular cartilage repair device 4 Inter-articular cartilage repair device distal end 6 Inter-articular cartilage repair device proximal end 8 Cylindrical body of inter-articular cartilage repair device 10, 12 More than one half-moon shape (crescent shape) on cylindrical body Groove 14 Applicator 16 Spring-biased plunger 18 Slender tube 28 Spring

Claims (6)

[Claims] An elongated device body having a sharpened distal end and a blunt proximal end, and a plurality of grooves extending between the distal end and the proximal end along the length of the device body. Are cut to form a plurality of edges, the edged groove provided in the front half near the distal end bordering the middle between the distal end and the proximal end, The mouth is open toward the base, and the edged groove provided in the rear half near the base end is characterized in that the mouth is open toward the distal end, and tissues of the human body such as torn interarticular cartilage are characterized. Repair device. 2. The device according to claim 1, wherein the device body has opposite side edges, and the grooves are respectively arranged on the both side edges. 3. The plurality of grooves form a fixed pattern, and the plurality of grooves formed on one of the side edges are staggered with respect to the plurality of grooves formed on the other of the side edges. 3. The human tissue repair device of claim 2, wherein the device is arranged. 4. The device body has a substantially constant diameter from the distal end to the proximal end, and has a form like a harpoon inserted into human body tissue. A tissue repair device for a human body. 5. Means having a distal end and a proximal end inserted into tissue of a human body, means for engaging said tissue to prevent movement in the proximal direction, and engaging said tissue. Means for preventing movement toward the distal end of the human body. 6. A method for repairing a human tissue such as a torn joint cartilage using a human tissue repair device such as a torn joint cartilage, wherein the repair device comprises a sharp tip and a sharp tip. A long and thin device body with a base end that is not provided, and a plurality of grooves are cut along the length of the device body between the distal end and the base end to form a plurality of edges. The edged groove provided in the front half near the distal end portion bordering the middle between the distal end portion and the proximal end portion, the mouth opens toward the proximal end portion,
The edged groove provided in the rear half portion near the base end portion has an opening toward the distal end portion, and the method includes mounting the repair device on a tubular portion of an applicator, and Insert the tubular portion of the applicator in a direction perpendicular to the tissue to be repaired, such as the tissue of interarticular cartilage having a joint laceration, and operate the applicator to move the repair device into the tissue. A method for repairing a tissue of a human body, wherein the tissue is repaired by leaving the repair device in the tissue so as to bite and suture the tissue.